Clinical use and complications of percutaneous cystostomy pigtail catheters in 25 cats

Abstract

Objectives The aims of this study were to describe the indications for percutaneous pigtail catheter placement in cats requiring urine diversion, and to report the associated intra- and postoperative complications. Methods The medical records of cats that underwent percutaneous pigtail catheter placement for urine diversion between January 2011 and May 2021 were retrospectively reviewed. Results Twenty-five cats were included. Indications for pigtail catheter placement were medical management of obstructive urinary tract disease (n = 12), urinary tract damage after traumatic injury (n = 8) and neurological bladder dysfunction (n = 5). Catheters were in place for a median time of 8.28 days (range 3–27), and the duration of the catheter placement was not different between the medical, traumatic and neurological groups. Ten cats (40%) developed pigtail catheter complications including dislodgement, urine leakage, urinary tract infection and bladder rupture. The majority of complications were easily resolved and did not require surgical intervention. Conclusions and relevance The results suggest that percutaneous pigtail catheter placement can facilitate urine diversion in both the emergency setting and in the long-term management of urine retention without many complications.

Case report: Utility, complications, and short-term outcomes in three dogs managed with percutaneous pigtail cystostomy catheters for urethral obstruction

“…Cats that had similar pigtail cystostomy catheters placed were found to have a 40% complication rate, including dislodgement, urine leakage, urinary tract infection, pyrexia, and bladder rupture ( 5 ). Most complications were minor and did not affect quality of life.…”

“…The first operator in Case 2 did not have prior experience in the procedure, which may have contributed to the unsuccessful attempt. Tubes were not sutured to the abdomen as described in previous studies ( 4 , 5 ), which could have resulted in kinking, increased movement, and subsequent urine leakage.…”

“…A technique for ultrasound-guided percutaneous placement of a pigtail cystostomy catheter has been described to achieve temporary urinary diversion in a dog ( 4 ). The utility and complications associated with this procedure have been described in cats ( 5 ) but not in dogs. This report describes the utility, complications, and short-term outcomes of three dogs managed with percutaneous pigtail cystostomy tubes placed in the ER for unalleviated mechanical urethral obstruction.…”

Urinary tract trauma in cats: stabilisation, diagnosis and management

“…The use of a percutaneous cystotomy pigtail catheters is also suitable for urinary diversion in the cat; however, a 40% complication rate was noted in one study of urine leakage, dislodgement, urinary tract infection and bladder rupture. 17 Placement of a cystostomy tube (see box on pages 10 and 11) is advised for prolonged urinary diversion and, in particular, when there is significant trauma to the lower urinary tract or R E V I E W / Urinary tract trauma in cats neurological dysfunction. This requires general anaesthesia and can be performed via a ventral midline approach 18 or a minimally invasive approach.…”

“…The use of a percutaneous cystotomy pigtail catheters is also suitable for urinary diversion in the cat; however, a 40% complication rate was noted in one study of urine leakage, dislodgement, urinary tract infection and bladder rupture. 17 …”